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Special report: The end of traditional mammography?

by Carol Ko, Staff Writer | July 19, 2013
International Day of Radiology 2012
From the July 2013 issue of HealthCare Business News magazine

Siemens MAMMOMAT Inspiration

One downside of the modality is that it uses more dose than traditional mammography. Indeed, mammography systems are currently raising the bar even higher on dose reduction—Siemens Healthcare recently announced that their latest mammography , the Mammomat Inspiration Prime Edition, was approved by the FDA for breast cancer screening. The system is designed to reduce dose up to 30 percent, according to the company.

But new digital tomosynthesis software that received FDA approval in May may help level the playing field.

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Current digital tomosynthesis systems perform two scans: the first scan takes a range of image slices of the breast while the second scan takes a traditional 2-D image.

Hologic’s C-View 2-D imaging software reconstructs regular 2-D pictures from the tomo slice sweep to avoid the second scan. Now, images generated by this software can be used in place of conventional 2-D mammograms.

However, some doctors still have reservations regarding wholehearted adoption. “Digital tomo is going to be a financial burden on patients. Patients are paying 50 to100 dollars for tomo. You’re going to increase disparities in terms of access. You wonder if we’re going to have a two-tiered system where you get more if you pay more,” says Lee.

Cost isn’t the only worry. “There are still a lot of unknowns and I think the concern from physician standpoint as a radiologist is that this will put a lot of pressure in terms of patient volume on our practices,” says Lee.

Mammography redone
No matter where experts fall in the mammography debate, they all agree that traditional mammography screening is going to change. A one-size-fits-all screening regimen for women no longer makes sense, they say. “It’s time to have risk stratified screening for patients who need it most,” says Ohio State University’s White.

Still, not all doctors think more screening is better. “Not a lot of radiologists will say this to you, but there are different groups we’re over-imaging. Is there a way we can reduce cancer while tailoring screening to a woman’s needs? We’re just getting into that realm with research and new technologies and it would be just horrible to stop,” says Conant.

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